In clinical and outpatient practice, doctors and health operators make wide use of portable instruments, frequently used both to evaluate the main physiological conditions of the patient and for treatment purposes, as also to communicate or register clinical data.
The hygiene of such instruments is of fundamental importance in that it is known how a lack of sterility thereof often entails serious health risks. In fact, a significant percentage of infective disease is of iatrogenic origin, linked mainly to a lack of hygiene. Such diseases, as well as obviously impairing the health of the patient, significantly increase clinical and health costs.
The majority of portable instruments are disposable and as such, are suitably closed in sealed sterile packaging; these comprise needles, syringes, gauzes, electrodes etc.
Other instruments, generally more expensive, used by health care personnel, such as forceps, clamps, surgical instruments, catheters etc. are sterilised before use each time in special machinery, generally considerably expensive, cumbersome and sophisticated, located in specific areas quite separate from the operating theatres.
There are however various instruments used by healthcare operators (primarily doctors), such as stethoscopes, thermometers, manometers, otolaryngological retractors, ophthalmic frames and lenses, etc. the hygienisation of which must necessarily be performed frequently and repeatedly, whenever use is required in different subjects.
Unfortunately, despite the problem of cross infection (from doctor to patient and from patient to patient through non-disposable medical instruments) being widely known, evident and ascertained at a scientific level, and there being a wide perception of the elevated efficacy of meticulous hygienisation of such instruments to prevent hospital infections, little attention is paid by doctors and healthcare operators to performing systematic hygienisation of the instruments between one patient and the next. This is often due to practical reasons and the priority of medical treatment which focuses mainly on treating the patient and restoring his vital functions.
Among the frequently and repeatedly used instruments, and thus a possible vehicle of infection, the stethoscope is the most common, with a high risk of transmission of iatrogenic infections. The function of the stethoscope, by means of contact of the head thereof with various parts of the patient, is to detect the sounds of the patient's organs and interpret them so as to determine the physiological or pathological conditions thereof.
There is wide evidence in the literature that stethoscopes may be a vehicle of cross infection from one patient to another. In fact, it is rare, albeit desirable, for a doctor to disinfect a stethoscope after each examination.
A fundamental role in the lack of attention to hygienisation is the practical difficulty of adequate hygienisation/sterilisation in the normal operating conditions of the doctor. The stethoscope is, in fact, an instrument which a doctor generally brings with him during his visits, often itinerant, while, as said, sterilisation devices are normally cumbersome and housed in dedicated rooms. Consequently, even in the case in which disinfecting were carried out by the doctor after each examination, it would, more often than not, be hurried, inadequate and in any case uncontrolled as regards efficacy and safety.
Hygienisation systems which are simple, lightweight, compact, portable, safe and reliable both in safeguarding healthcare operators and patients, and in the efficacy of their action, are therefore desirable.
To hygienise or sterilise medical-healthcare instruments either chemical substances, or approaches based on physical mediums may be used. The latter, compared to the former, do not suffer from microbial resistance nor do they generate it in that they do not use selection mechanisms but are generally associated with cumbersome and expensive devices and are thus typically intended for hospital use.
Among the effective and tested physical systems is the one using UV rays. It has been demonstrated that UV rays have a safe disinfectant property (lowering of the microbial content), especially in the range of wavelengths between 255 and 280 nm, with a sterilising effect (elimination of the microbial content) when exposure time is sufficiently prolonged.
Hygienisation devices have been proposed which function on the UV ray principle. However, on account of the space they occupy, the inconvenience of use, complexity and elevated cost, they do not configure as a real solution to the problem highlighted above.
One important parameter in the design of a device of this type is the safety of the operator and the patient, in particular to avoid skin and eye damage caused by UV rays. This problem too has not been resolved by the devices of the prior art in a practical and economical way.